Editorial: Dialectical Behavior Therapy: More Is Not Always Better When Different Is Required.

The study by Berk et al.1 highlights potential trajectories of response and nonresponse to dialectical behavior therapy (DBT) as compared to individual and group supportive therapy (IGST) for teens with repeated self-harm and suicidal ideation. The authors also posit a testable function to predict responsiveness vs nonresponsiveness and provide critical guidance about when to reassess nonresponders and alter treatment. This is the fourth major article from a large federally funded, randomized controlled trial. Previous publications have highlighted superiority of DBT over IGST,2 reported the moderating factors of treatment outcomes,3 and explored the mechanism of effectiveness for DBT in the treatment of suicidal ideation and self-harm.4 These articles provide useful information given the rising rates of suicidal ideation and suicide attempts among youth5 and recent research suggesting the powerful role of social media in supporting contagion of suicidal behavior among youth.

Editorial: Dialectical Behavior Therapy and the Function of Self-Injury.

The study by Asarnow et al.1 is the third major paper from a large, federally funded, randomized, controlled trial of dialectical behavior therapy (DBT) as compared to Individual and Group Supportive Therapy (IGST) for reducing self-injury in teens. The first paper established the superiority of DBT as compared to IGST.2 The second paper focused on predictors and moderators of treatment outcome.3 The goal of this, the third, publication1 is to identify the mechanism by which DBT is effective in reducing suicidal and self-injurious behavior in an at-risk group of adolescents. The value of DBT in reducing suicidal behavior is increasingly important as we face what appears to be a rise in attempt rates and suicide deaths during the COVID-19 pandemic.4.